1 / 34

Neurology 2

Neurology 2. Part 3. Assessing Motor System. Muscle Strength Tone Tension pressure when the muscle is at rest Spasticity Increase muscle tone Rigidity Resistance to passive stretch . Flaccidity Decreased muscle tone Atrophy Wasting away of muscle Hypotonia Lose of tone or strength

chill
Télécharger la présentation

Neurology 2

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Neurology 2 Part 3

  2. Assessing Motor System Muscle Strength • Tone • Tension pressure when the muscle is at rest • Spasticity • Increase muscle tone • Rigidity • Resistance to passive stretch

  3. Flaccidity • Decreased muscle tone • Atrophy • Wasting away of muscle • Hypotonia • Lose of tone or strength • Atonia • No tone or strength

  4. Hypertonia • Increased tone or strength • Gait • Manner / style of walking • Ataxia • Failure of muscle coordination, irregular voluntary muscle action • Akinesia • Abnormal absence of movement • Bradykinesia • Slow movement

  5. RAM Rapid Alternating Movement Pronate / supinate Balance & Coordination Cerebellum assessment

  6. Point to Point

  7. Heel to Shin

  8. Heel to toe walking • Hopping in place

  9. Have the patient walk across the room under observation. • Next ask the patient to walk heel to toe across the room, • Then on their toes only, • finally on their heels only.

  10. Romberg • Stand feet together arms at side • Eyes open • Eyes closed 20-30 seconds • Slight sway is normal

  11. Assessing Reflexes Grading Scale 0 = No response + = hypoactive ++ = Normal +++ = More active ++++ = Hyperactive

  12. Deep Tendon Reflexes

  13. Deep Tendon Reflexes Biceps • Thumb on the biceps tendon • Strike your thumb with hammer • Compare with other arm

  14. Deep Tendon Reflexes Triceps • Strike the triceps tendon directly with the hammer while holding the patient's arm with your other hand. • Repeat and compare to the other arm.

  15. Deep Tendon Reflexes Patellar

  16. Deep Tendon Reflexes Achilles

  17. Superficial Reflexes (protective reflexes) • Corneal Reflex • Test using a clean cotton wisp, lightly touch the outer corner of each eye on the sclera • Normal: (+) elicits a blink • Abnormal: (-) no blink • Eye protection • Lubrication

  18. Superficial Reflexes (protective reflexes) • Gag reflex • Test: gently touch posterior pharynx with cotton applicator • Normal: (+) elevation of the uvula (gag) • Abnormal: (-) No gag • NPO

  19. Superficial Reflexes (protective reflexes) • Plantar Reflex • Test: stroke the lateral side of the foot with tongue blade • Normal: (- Babinski) toe flexion (curl) • Abnormal: (+ Babinski) toe tanning

  20. - Babinski = Normal + Babinski = Abnormal Superficial Reflexes (protective reflexes)

  21. Vital Signs • Temperature • With head trauma  increased

  22. Vital Signs • Pulse • Strength, rate rhythm • Bradycardia  indicative of Increased ICP

  23. Vital Signs • Respirations • Depth, rate, rhythm, effort • Ataxic • Damage to medulla • Cheyne-stokes • Lesion deep in both hemispheres, basal ganglia and upper brainstem • Hyperventilation • Metabolic problems or brainstem

  24. Vital Signs • Blood Pressure • Right verses left • Lying verses standing • Difference in systolic by > 20mmHg  potential cerebral ischemia

  25. Pulse Pressure formula: Systolic – diastolic 120 ------ = ? 80 Vital Signs

  26. Vital Signs • Pulse Pressure • Systolic – diastolic 120 ------ = 40 80 • Normal Pulse pressure = 40 • Widening pulse pressure = Increased ICP

  27. Neuro Checks • LOC • Pupils • PERRLA • Pupils • Equal • Round • Reactive to • Light • Accommodation

  28. Neuro Check • Pupils • Anisocoria • Inequality in the size of the pupils • Nystagmus • Progressive dilation •  Increase ICP • Fixed & dilated • Injury at level of midbrain

  29. Brudzinski’s • Flexion of the neck  pain and flexion of the knees • Indicates • Meningitis • No not perform if… • Neck or back injury

  30. Kernig’s • Pain with flexion of the hip and knee • Indicates • meningitis

  31. Cushing Sign • Vital sign changes assoc. with Increased ICP • Increase in Systolic pressure • Widening pulse pressure • Bradycardia • Bradypnea (slight)

  32. Day 2 Diagnostic tests

More Related